Locust Street Resource Center Cila #1
NPI #1700330545 in Carlinville, Illinois
Provider Information
- NPI Number
- 1700330545
- Entity Type
- Organization
- Organization Name
- Locust Street Resource Center Cila #1
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- LOCUST STREET RESOURCE CENTER
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Aug 10, 2016
- Last Updated
- Jul 21, 2022
Practice Location
- Address
- 124 W BUCHANAN ST
- City
- Carlinville
- State
- Illinois
- ZIP Code
- 62626-1027
- Phone
- (217) 854-3166
Authorized Official
- Name
- MRS. TRACY HAYNES
- Title
- MANAGER
- Phone
- (217) 854-3166
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center) |
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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